PSHFE Membership Application

Associate membership - $200

Voting membership $60 - must work for a healthcare providing facility that operates in Pennsylvania

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* 1. First Name

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* 2. Last Name

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* 3. Title

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* 4. Organization Name

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* 5. Street Address

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* 6. City

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* 7. State

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* 8. Zip Code

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* 9. Phone Number

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* 10. Email Address

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* 11. Secondary Contact Email Address Option (Associate members only)

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* 12. Are you currently a member of ASHE (American Society for Health Care Engineering)?

Yes

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* 13. Dues payment preference (note: your membership will not be processed until payment is received)

I will pay via credit card through the PSHFE home page using the 'Make a Payment' button

I will mail a check/money order to P.O. Box 212, Middletown, PA 17057 (be sure to include your name on the payment)

I have heard about your complimentary membership offer valid through 4/18/24 and would like to take advantage of that. (Must be new to PSHFE and be eligible for voting membership (must work for a health care provider within the state of Pennsylvania)).